| NPI | 1225403892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: MO 2015015202) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: KS 01-05728) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2021-01-02 |